Comparison of the Efficacy of Paclitaxel-releasing Balloon Catheter System Versus the Everolimus-Eluting Stent System for Treatment of In-Stent Restenosis Lesions - Harmonizing Optimal Strategy for Treatment of In-Stent Restenosis Lesions (The HOST-ISR Trial) -
Recruitment status was Not yet recruiting
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Purpose
In-stent restenosis (ISR) lesions are considered one of the toughest lesions that interventional cardiologists encounter in the drug eluting stent (DES) era. The current consensus in treating ISR is implantation of another DES into the restenosed segment. However the recent results of paclitaxel-releasing balloon catheter (PRBC) in ISR lesions have been very encouraging. The aim of HOST-ISR trial is to investigate the efficacy and safety of PRBC compared with everolimus-eluting stent (EES) in preventing neointimal growth in ISR lesions. HOST-ISR trial is a multicenter, open-label, prospective, randomized trial to test whether PRBC is non-inferior to EES in preventing neointimal growth in ISR lesions. It plans to enroll a total of 264 patients with ISR, randomizing the cohort 1:1 to either PRBC or EES. The primary endpoint will be in-segment late luminal loss at 9 months angiographical follow-up.
| Condition | Intervention | Phase |
|---|---|---|
|
In-stent Restenosis Lesion |
Device: Paclitaxel-eluting balloon catheter Device: Everolimus-eluting stent |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Treatment |
- Late luminal loss in the analysis segment [ Time Frame: 9 months ] [ Designated as safety issue: No ]Analysis segment is defined as +/- 5mm of the previous stented/inflated segment of the vessel
- Late luminal loss in the inflation/in-stent segment [ Time Frame: 9 months ] [ Designated as safety issue: No ]
- Target lesion/vessel revascularization, myocardial infarction [ Time Frame: 1, 2 years ] [ Designated as safety issue: No ]
- Periprocedural myocardial infarction [ Time Frame: 3 days ] [ Designated as safety issue: Yes ]
- % diameter stenosis in the analysis segment & in the inflation/in-stent segment [ Time Frame: 9 months ] [ Designated as safety issue: No ]
- Neointimal volume, % neointimal volume, % volume obstruction [ Time Frame: 9 months ] [ Designated as safety issue: No ]The above parameters will be assessed by IVUS
- Time interval from device insertion to initiation of deployment [ Time Frame: 0 days ] [ Designated as safety issue: No ]
- Stent thrombosis [ Time Frame: 1, 2 years ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 264 |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Paclitaxel-eluting balloon catheter
Paclitaxel-eluting balloon catheter use for treatment of ISR lesion
|
Device: Paclitaxel-eluting balloon catheter |
|
Active Comparator: Everolimus-eluting stent
Everolimus-eluting stent use for treatment of ISR lesion
|
Device: Everolimus-eluting stent |
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age at least 18y
- Significant ISR lesion (>50% by visual estimate) of previously stented de novo coronary artery
- Evidence of myocardial ischemia (e.g., stable, unstable angina, recent infarction, silent ischemia, positive functional study or a reversible changes in the electrocardiogram (ECG) consistent with ischemia) or ISR with diameter stenosis > 70%
- Written, informed consent
- Target lesion(s) located in a native coronary artery within a previously stented lesion with previous stent diameter of ≥ 2.5 mm and ≤ 4.00 mm
- Target lesion(s) amenable for percutaneous coronary intervention
Exclusion Criteria:
- Hypersensitivity to aspirin, clopidogrel, heparin, sirolimus, paclitaxel or radiocontrast media
- Systemic sirolimus use within 12 months
- Female of childbearing potential
- History of bleeding diathesis or known coagulopathy (including heparin-induced thrombocytopenia)
- Gastrointestinal or genitourinary bleeding within the prior 3 months, or major surgery within 2 months
- Non-cardiac co-morbid conditions present with life expectancy <1 year or that may result in protocol non-compliance
- Patients who are actively participating in another drug or device investigational study, which have not completed the primary endpoint follow-up period
- ISR of left main coronary artery
- Restenosis of two stented bifurcation lesion
Contacts and Locations| Contact: Kyung-Woo Park, MD, PhD | 82-2-2072-2044 | kwparkmd@snu.ac.kr |
| Contact: Hyo-Soo Kim, MD, PhD | 82-2-2072-2226 | hyosoo@snu.ac.kr |
| Korea, Republic of | |
| Seoul National University Hospital | Not yet recruiting |
| Seoul, Korea, Republic of, 110-744 | |
| Principal Investigator: Hyo-Soo Kim, MD, PhD | |
More Information
No publications provided
| Responsible Party: | Seoul National University Hospital IRB, Seoul National University Hospital |
| ClinicalTrials.gov Identifier: | NCT01093300 History of Changes |
| Other Study ID Numbers: | HOST-ISR trial |
| Study First Received: | March 24, 2010 |
| Last Updated: | March 24, 2010 |
| Health Authority: | South Korea: Korea Food and Drug Administration (KFDA) |
Additional relevant MeSH terms:
|
Everolimus Sirolimus Paclitaxel Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Antibiotics, Antineoplastic Antineoplastic Agents |
Therapeutic Uses Antifungal Agents Anti-Infective Agents Anti-Bacterial Agents Tubulin Modulators Antimitotic Agents Mitosis Modulators Molecular Mechanisms of Pharmacological Action Antineoplastic Agents, Phytogenic |
ClinicalTrials.gov processed this record on May 21, 2013